Irrational Fixed Dose Comdinations
Irrational drug combinations could cause increased organ failures
Thursday, January 05, 2006 08:00 IST Nandita Vijay, Bangalore
Irrational drug combinations are liable to increase the incidences of kidney failure, cardiovascular problems and trigger pancreatic malfunction resulting in the early onset of diabetes, stated P S Bhagavan, former deputy director (pharmacy), Karnataka directorate of Health & F W Services, Bangalore.
"There is a need to focus on the quality of life of patients while prescribing drugs for relief from pain or fever," he said.Referring to the issue of Crocin Quik the former deputy director (pharmacy) stated that it needs to be examined from a public interest point of view. Multiple drug formulations in Crocin Quik - paracetamol and sodium bi carbonate should be understood by medical practitioners and the pharmacists before they are handed over to patients as OTC drugs.There are several instances where doctors had a poor understanding of the multi-drug formulations. These include estolate from sterate of erythromycin, cemetidine and ranitidine when the latter was introduced, old Suganril with oxyphenbutazone and new Suganril with piroxicam when the latter replaced the earlier one, former Baralgan and the new Baralgan, old Novalgin and new Novalgin, and a plain tablet formulation and a sustained release coated tablet formulation.
"It would be futile to expect good understanding among the consumers to know the helpful and harmful affects of such drugs which are sold under the OTC category," Bhagvan said. Paracetamol does not cause 'immediate local irritation', but the addition of sodium bi- carbonate could harm the liver over a period of time if the combination is taken regularly.In a scenario where counselling by pharmacists is absent, there is a need to ensure over medication of OTC drugs."Hence the issue is whether introducing such drugs is safe in the public interest. This calls for a strong National Drug Policy covering all these issues.
The panel that assists the Drugs Controller General of India should include experienced hospital pharmacists before approving such formulations," stated Bhagavan.